Department of Medicine & Therapeutics, Chinese University of Hong Kong, Hong Kong, China.
Expert Rev Med Devices. 2009 Nov;6(6):611-20. doi: 10.1586/erd.09.45.
Atrial fibrillation is associated with a fivefold increased risk for stroke, mostly secondary to thromboembolic events. Anticoagulation with a vitamin K antagonist is the standard medical therapy for these patients but is difficult to maintain within the therapeutic range and requires frequent monitoring and dose adjustments. Approximately 90% of thromboembolism occurs in the left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation. Occlusion of flow into the LAA may prevent thrombus formation in the appendage and, hence, reduction of stroke. Recently, several percutaneous transcatheter techniques of LAA exclusion using the Percutaneous Left Atrial Appendage Transcatheter Occlusion device, the WATCHMAN device, and AMPLATZER septal occluder and cardiac plug have been employed, with encouraging results. Occlusion of the LAA may be an alternative to vitamin K antagonist therapy for selected patients.
心房颤动使中风的风险增加五倍，主要是由于血栓栓塞事件引起的。对于这些患者，维生素 K 拮抗剂抗凝是标准的医学治疗方法，但很难将其维持在治疗范围内，需要频繁监测和剂量调整。大约 90%的非瓣膜性心房颤动患者的血栓栓塞发生在左心耳（LAA）。阻塞 LAA 的血流可能会防止血栓在附壁上形成，从而减少中风的发生。最近，使用经皮左心耳经导管封堵装置、WATCHMAN 装置和 AMPLATZER 隔塞器和心塞已采用了几种经皮 LAA 封堵的经导管技术，结果令人鼓舞。对于某些患者，LAA 的闭塞可能是维生素 K 拮抗剂治疗的替代方法。
